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VAERS Report 2136970

Case Report Section

Détails du rapport Vaer

Âge: N/A

Genre: Male

Région : Outside US

Patient décédé?
Non
Renseignements sur les vaccins

Nom: COVID19 (COVID19 (PFIZER-BIONTECH))

Type : Coronavirus 2019 vaccine

Fabricant: PFIZER

Lot: fe8244


Date de réception du rapport
2022-02-24
Date à laquelle le formulaire est complèté
Date de vaccination
2021-08-14
Date d’apparition
75
Nombre de jours (date d’apparition – date de vaccination)
75
Description de l’événement indésirable

this is a spontaneous report received from a contactable reporter(s) (physician) from the regulatory authority-web. regulatory number: at-basgages-2022-015161 (ra). a 31 year-old male patient received bnt162b2 (comirnaty), intramuscular, administration date 14aug2021 (lot number: fe8244) as dose 2, single and intramuscular, administration date 02jul2021 (lot number: fd6840) as dose 1, single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. the following information was reported: drug ineffective (medically significant) with onset 28oct2021, outcome "unknown", described as "vaccination failure"; covid-19 (medically significant) with onset 28oct2021, outcome "unknown", described as "sars-cov-2 infection". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: (28oct2021) positive, notes: variant pcr-based: b.1.617.2 variant sequenced: n/a. n501y positive: no. no follow-up attempts are possible. no further information is expected. sender's comments: linked report(s): at-pfizer inc-202200293729 same patient/product, different dose/events

Données de laboratoire
test date: 20211028; test name: covid-19 pcr test; test result: positive; comments: variant pcr-based: b.1.617.2 variant sequenced: n/a. n501y positive: no
Liste des symptômes
drug ineffective covid-19 sars-cov-2 test
Patient décédé?
Non
Date de décès
N/A
Anomalie congénitale
false
Vaccin administré par :
Other
Vaccin acheté par :
Inconnu
Visite d’un patient à l’urgence?
Non
Patient hospitalisé?
Non
Séjour à l’hôpital
Non
Nombre de jours à l’hôpital
Non spécifié
Invalidité permanente?
Non
Allergies:
na
Maladie actuelle
na